Friday, August 14, 2009

The Pill vs Fertility Awareness

Do you trust The Pill to keep you from getting pregnant without messing up your body? I don't. My last post on the effect of breastfeeding on child spacing got some thought provoking comments (particularly Earthenwitch's) about fertility awareness. Would we benefit from having more knowledge about our own fertility? It's a difficult question: a little knowledge is a dangerous thing, as the saying goes.

If you are a man or you don't like talking about cervical mucous then you might want want to look away now. So here goes. Several years ago I started taking the contraceptive pill; it just seemed to be the normal thing to do. Within the first year of taking it, I began to feel lethargic and sad. I took B vitamins in an attempt to combat my lack of energy, but they did not seem to make any difference.

My doctor seemed unconcerned about the side-effects but I did manage to persuade him to change my prescription to a different brand of pill. And I did begin to feel better, though I don't know whether it was the new pills or the placebo effect that made the difference. But over the next couple of years I found that my breasts became increasingly sore in the days before my "period" and my interest in sex diminished. This kind of defeated the whole pill-taking exercise.

I think I got off fairly lightly with my minor complaints; a quick web search reveals a list of side-effects as long as your arm, including:

* Weight gain (average of 10lbs in the first year)
* Increase or decrease in acne
* Nausea and vomiting
* Dizziness
* Headaches
* Depression
* Vaginal infections
* High blood pressure
* Loss of libido
* Blood clots in legs, lungs, heart or brain
* Stroke
* Liver tumors (rare)
* Heart attacks
* Gallstones (rare)
* Jaundice (rare)
* Possibly cervical cancer

One morning I woke up, came to my right mind and decided I had had enough of stuffing synthetic hormones down my neck. It is much easier to do this when you are in a stable relationship within which pregnancy would not be a disaster, and I would not for a minute encourage other people to come off the pill. But for several years before we conceived intentionally, I mentally tracked my fertility and used contraceptives only on the days when I was most likely to get pregnant. This is not too difficult when your cycles are regular like mine and it requires no more knowledge than A-level biology.

Disclaimer: NOBODY should trust their own contraception to the instructions in the following paragraph! It is a gross simplification of natural fertility awareness and I will NOT be held responsible for any unwanted pregnancies! With that clear, I shall continue. To avoid conceiving you basically need to know when you ovulate, and use barrier contraception before and after that day. You can easily find out when you ovulate by observing your cervical mucous for a few cycles. Ovulation is accompanied by a sudden increase in clear, stretchy mucous and if you don't see it when you go to the toilet then - yes girls - you just have an exploratory feel (you know where) and see what you can find (as a rough guide, ovulation usually takes place 11-14 days after the first day of your period). Given that sperm can live for 2-3 days, you need to use a barrier method for a good 5 days or so before your predicted ovulation date. And after ovulation, I'm careful for another 5 days or so, just to be on the safe side.

The good thing about being aware of your own fertility, apart from avoiding nasty hormone pills, is that when you do want to become pregnant, you are already aware of the days when you are most likely to conceive.

Now I repeat that nobody should base their own family planning on this information. But I do think that with a bit of knowledge about fertility it is possible to avoid taking the pill without losing too much spontaneity in the bedroom. If you are in a position where pregnancy is undesired but not unthinkable, natural fertility awareness is a realistic option. A bit of cervical mucous monitoring has to be preferable to that terrifying list of side-effects, doesn't it?


Lisa - edenwild said...

I think being aware of one's own fertility would be a very empowering thing. I mentioned before that I can't risk pregnancy right now (for health reasons, and I also can't use LAM-because of bf problems in the beginning I got my period back right away) so I use an IUD (non-hormonal, I would literally go psycho if I was on the pill, I am certain). ANYWAY, even though I don't NEED to, I am thinking of tracking my ovulation anyway. I would like to be more in tune with my body, which is always a good thing. And if we decide it would be safe for me to get pregnant again, it could be very helpful!

PS--THAT'S what that mucous is??

TopHat said...

I've always been able to tell when I'm ovulating- ovulation pain! I remember in high school waking up with ovulation pain and thinking, "If I had sex today, I'd get pregnant."

Of course, I wish someone had told me about mucous. I once went to my mom when I had quite the excess and asked her about it. She just said it was a woman thing and to ignore it- it's fine. Maybe she didn't know either. I just wish someone had told me what it was for and what it meant.

Liz said...

I've used Fertility Awareness as learned in detail from Toni Weschler's excellent book Taking Charge Of Your Fertility for many yars, both to get pregnant when medical science hadn't helped and overcoming significant fertility problems (PCOS) and to avoid pregnancy.
The only people I've met who have become pregnant using forms of 'natural fertility' have not followed the rules properly, or not been aware of all the rules for using it safely. And that goes double for LAM - most people seem to think it's merely breastfeeding=protection, rather than known the actual rules of LAM. I think Fertility Awareness should be required teaching for both boys and girls at school!

allgrownup said...

I didn't know about this stuff. I tracked my temperatures and recorded it on a little cahrt for months to concieve 1st time round, I still had little idea as my cycle is very irregular. (Although my hubby is very aware of my physical cues, and will say "you're due on your period, that's why you feel ill." and the next day I will get my period....glad someone pays attention!) In the past, I've used the implant as contraception, that uses one hormone, not a cocktail like many pills, and whilst using, I suffered severe headaches, panic attacks and then depression. I hadn't put two and two together until recently. In fact, hubby pointed it out. From then on, we used two types of barrier method.

Beth said...

This post is really funny for me because I was just talking with my fiance last night about this. (Before I saw this post)

I can't really go on birth control, I know shocker. I am 22 and pretty healthy but those pills kill my body. They make me so sick and increase my cramps ten-fold. Which is unacceptable as my cramps are already excruciating to begin with (and no I am not prone to exaggeration.)

I have been looking into this method of birth control for a while. What books and other materials would you recommend?

By the way I love your posts. You are a really great writer.

Jessica said...

I told a friend recently who was trying to get pregnant, "When you got the goop, get to having sex."

She had no idea what I was talking about, then thought for a second and exclaimed, "Oh!!! Really??"

Yep. Just that simple. And now she's due in December!

Cave Mother said...

Hi Beth

I'm afraid I can't really recommend any books because as I said, I just know enough biology to make it up as I go along. But Liz has recommended Toni Weschler's Taking Charge Of Your Fertility and her book choices are always great - so I hope that helps!

Beth said...

That does help. I am a biology/education major (I want to teach high school) hence my interest in this as well. Thank you!

Earthenwitch said...

I'm going to give that book a look, so thanks to Liz and to you for this post; pregnancy wouldn't be a disaster at the moment although it's not something we're actively seeking, and I would really like to continue the sense of in-touchness that I started to feel when I was pregnant and subsequently breastfeeding. To be honest, I always thought the whole idea of the natural/rhythm method was a bit hokey, but the way you put it, hell, why not, when compared with that list of side-effects (particularly as I have a family history of breast cancer, and as such the pill doesn't feel like a good option for me).

Kimberly said...

When I read Taking Charge of Your Fertility so many things about my body clicked into place. I always thought my cycles were irregular-they're not they're just a full week longer. So many times I would panic thinking I was pregnant before I started tracking.

I used the pill for 3 months, but it was so expensive! I wouldn't go back to taking it now, since using a barrier method has worked great for 3 years.

Joe said...

I had a load of side effects from the pill too, although I wasn't quite aware of it at the time. I did have to change at some point - after months of mono-like symptoms, and tests for that and thyroid dysfunction and etc., my doctor finally clicked and switched me to a new pill. And it worked instantly.

I was ok on that 2nd pill, but getting pregnant was in a way a great eye opener for me: while striving for the best for my daughter, I became so much more aware of little things we take for granted but can make a big difference, and strive for more natural alternatives where I can.

I also don't want to go back to stuffing up some synthetic hormones... Since my pregnancy, it feels as if my body got back into a natural rhythm: my cramps are much less than they were, my cycles are actually regular, and I can see the mucous when I ovulate, something I didn't even get when on the pill. I'm much more in-tuned with myself and my body, and that's actually a pretty empowering thing!

It just takes a bit of basic knowledge to prevent/promote pregnancy, and if you want to take it further, there's some great resources. I keep meaning to check that book as well!

The McTaggarts said...

HI! Wow, great post. My friend just introduced me to the book "Taking Charge of Your Fertility" and so far it's pretty awesome! I'm 21 years old and been married for over a year. I used to have the IUD but that didn't go over so well. Now I'm on the pill and that is so HORRID! I'm also experiencing symptoms of Fibromyaglia which is not fun, and the doctors take forever to even officially diagnose it. I have since April 09, every month experiencing pregnancy symptoms while on the pill. My doctor says this is normal but I was on the pill before (same one) and it didn't do this to me.

This is why I would like to start the FAM. It seems like such a good idea, although I am worried about one thing and perhaps someone can help me. I am still on the pill and don't want to get off of it until I really know my cycle, which tends to be so irregular. Last month it was 3 days of heavy. This month, it's over a week late (based on BC packet) with only two days of LIGHT spotting.

Is it possible to track while on BC or do I need to get off and switch to condoms until I know my cycle? Thanks!


Joe said...

I don't think it would be possible to track while on the pill, as the purpose of the pill is to in fact trick your body's cycle in the 28 days of the pills, by giving set amount of hormones that mimic what you would get on so so day of a 28 day cycles - if that makes sense?

The only way to know what's natural for YOUR body, if to get off the pill. Keep in mind that it may take 3-ish month (sometimes a bit more) for things to settle down into your natural cycle.

If that can be a bit of encouragement, my experience was being extremely irregular too when I first started (my periods), with usually heavy bleeding and INSANE cramps - for 1 week, every month (sometimes every 2 weeks!) I didn't go back on the pill after my pregnancy, and have had clear 28 days cycle since of only 3-ish days, and cramps only the first day. Of course, not everyone is the same, so I'm not saying it would solve all your problems :) But sometimes (often, actually) things are more rock 'n roll the first few years when you start, and settle down when you're out of your teenage years.

I'd say try it, and if things seem to get worse not better after 3-4 cycles, then you can talk about it with your doctor and see what are your options!
Good luck! :)